Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,728.94 / $1,728.94 / $1,728.94	Facility		$1,728.94	$1,728.94	$1,728.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,435.44 / $1,728.94 / $2,896.59	Professional		$1,435.44	$1,728.94	$2,896.59
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,427.30 / $3,770.03 / $6,237.69	Facility		$3,427.30	$3,770.03	$6,237.69
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,187.39 / $3,187.39 / $4,215.57	Professional		$3,187.39	$3,187.39	$4,215.57
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,465.58 / $7,334.42 / $7,334.42	Facility		$2,465.58	$7,334.42	$7,334.42
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,217.07 / $7,085.31 / $14,306.34	Facility		$2,217.07	$7,085.31	$14,306.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,618.46 / $4,966.41 / $6,486.43	Professional		$1,618.46	$4,966.41	$6,486.43
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $986.09 / $2,593.41 / $3,941.40	Facility		$986.09	$2,593.41	$3,941.40
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $1,962.38 / $3,345.13 / $4,112.76	Professional		$1,962.38	$3,345.13	$4,112.76
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,706.96 / $3,427.30 / $16,018.84	Facility		$1,706.96	$3,427.30	$16,018.84
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,547.95 / $2,290.02 / $3,731.90	Professional		$1,547.95	$2,290.02	$3,731.90
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $2,231.71	Professional		$50.00	$70.00	$2,231.71
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $986.09 / $2,593.41 / $3,941.40	Facility		$986.09	$2,593.41	$3,941.40
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $1,962.38 / $3,345.13 / $4,112.76	Professional		$1,962.38	$3,345.13	$4,112.76
Quartz Facility/Professional Professional Modifier Low / Median / High Price $3,427.30 / $5,274.49 / $9,164.78	Professional		$3,427.30	$5,274.49	$9,164.78
Quartz Facility/Professional Facility Modifier Low / Median / High Price $2,217.07 / $6,693.94 / $16,018.84	Facility		$2,217.07	$6,693.94	$16,018.84
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,618.46 / $2,217.07 / $17,255.00	Professional		$1,618.46	$2,217.07	$17,255.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $3,427.30 / $3,427.30 / $3,427.30	Professional		$3,427.30	$3,427.30	$3,427.30
Security Health Facility/Professional Professional Modifier Low / Median / High Price $3,427.30 / $3,427.30 / $3,427.30	Professional		$3,427.30	$3,427.30	$3,427.30
United Facility/Professional Facility Modifier Low / Median / High Price $2.44 / $2,298.57 / $2,353.73	Facility		$2.44	$2,298.57	$2,353.73
United Facility/Professional Professional Modifier Low / Median / High Price $1,272.86 / $2,060.50 / $3,427.30	Professional		$1,272.86	$2,060.50	$3,427.30